Ryan, Michael J
Ryan, Michael J is an individual health care provider with primary practice located at 232 S Whisperwood Way , Boise ID 83709-4900. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Ryan, Michael J can be contacted via phone (208) 350-6450.Contact Information
Primary practice address
232 S Whisperwood Way
Boise ID 83709-4900
Phone: (208) 350-6450
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | M5502 | Idaho |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | M5502 | Idaho |
Profile Details
| NPI number | 1821039025 |
|---|---|
| LBN Legal business name | Ryan, Michael J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Mar 12th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821039025 | NPPES |
| Idaho | MEDICAID | 003908900 |
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